Credentialing and Enrollment Coordinator

Synergy Orthopedics, LLC; New York (NY); On-site; USD 50,000 - 80,000; Full time

Job summary

Join a dynamic and rapidly growing organization as a Credentialing and Enrollment Coordinator. This role is pivotal in ensuring compliance with federal and state regulations while working closely with clinical and sales teams. You will manage contracts, develop compliance programs, and maintain necessary certifications to support our mission of providing top-notch orthopedic care. If you are self-motivated, detail-oriented, and eager to tackle compliance challenges, this is the perfect opportunity for you to make a significant impact in a thriving company dedicated to serving patients and physicians in the healthcare sector.

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

401k

Paid Time Off

Qualifications

• 3-5 years experience in compliance or credentialing is essential.
• Strong knowledge of DMEPOS laws and regulations is required.

Responsibilities

• Manage compliance programs and ensure adherence to regulations.
• Develop relationships with payers for contracts and fee schedules.
• Perform credentialing and maintain necessary certifications.

Skills

Excellent organization skills

Verbal communication skills

Ability to strategically address compliance challenges

Knowledge of DMEPOS laws and regulations

Independent judgement and discretion

Education

Bachelor’s Degree or higher in a related field

Job description

Job Opening: Credentialing and Enrollment Coordinator

Title:Credentialing and Enrollment CoordinatorBenefits: Medical, Dental, Vision, Life Insurance, 401k, Paid Time Off
Employment Type: Full Time

Objective

As part of our DMEPOS organization’s operations team, the Credentialing and Enrollment Coordinator will work alongside our Compliance Manager to ensure that our practices meet regulatory requirements, implement policies effectively, manage our contracts and mitigate risk within our healthcare operations. The Credentialing and Enrollment Coordinator will also work directly with our clinical and sales field representatives to monitor compliance and effectiveness. The ideal candidate must be self-motivated, comfortable working independently, and eager to take initiative.

Key Functions

• Assist in the continued development, modification and implementation of the overall
• Compliance Program including our Compliance Program training, audits, investigations and the development of policies and procedures, including HIPAA Compliance.
• Directly responsible for reviewing, analyzing and maintaining contracts to ensure they align with legal requirements and company standards.
• Develop relationships with payers to obtain, maintain and negotiate contracts and fee schedules.
• Perform all required credentialing, revalidation and accreditation applications to maintain compliance with various payers and governing bodies
• Renew and maintain all certifications, licenses, and registrations for the organization.
• Review and understand complex state and federal laws, regulations and Medicare billing policies related to DMEPOS suppliers, and make sure Synergy is always in compliance with our policies and procedures, especially as they relate to Medicare Supplier Standards, HIPAA privacy and security, and DME licensure. Frequent internal audits will need to be initiated, and outcomes addressed and corrected.
• Strategically and creatively address compliance challenges by planning, designing, implementing, maintaining and monitoring the Compliance Program while working effectively with key internal billing employees and Synergy’s field sales and service teams.
• Ensure that the company complies with federal, state, and industry regulations
• Promote ethical conduct and a commitment to compliance integrity programs

Accreditation

Synergy Orthopedics is a Medicare accredited company, as well as, independently accredited by the BOC Accreditation. At Synergy we take great pride in our Highly Rated Status as an accredited provider.

Competencies/Qualifications:

• Excellent organization and personal and verbal communication skills
• Bachelor’s Degree or higher in a related field
• 3-5 years experience working in compliance or credentialing
• Ability to strategically and creatively address compliance challenges
• Knowledge of DMEPOS laws and regulations
• Familiarity with operational, financial, and quality assurance procedures and regulations
• Ability to use independent judgement and discretion

About Synergy Orthopedics

Synergy Orthopedics is a dynamic, rapidly growing Third Party Biller of Orthopedic Bracing and Rehabilitation products focused on serving Patients and Physicians in the PA, NJ, DE, MD and NY State areas for a wide range of Orthopedic and Podiatric rehabilitation and surgical needs.